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9 day old latches, won't suck

1st time father here, trying to help my wife out. Our son was born 9 days ago and it seems that his breastfeeding is going backwards. Immediately after delivery, he latched well and sucked very hard. Wife fed him regularly for about 24 hours but became very raw. In house lactation consultant (IBCLC) said he was latching and sucking well but had been on the tip and told her to take 24 hours off to heal then showed us how to use curved-tip syringe. During that time she pumped every 2-3 hours and we would use what she produced and supplement with formula. We were also fighting jaundice at the time so the Dr said that it was important to keep input and output high so that's why we added formula. When she tried to resume breast feeding, he would still latch but did not suck nearly as hard and would either get fussy after a few minutes or would suck lazily for as long as she would allow him to stay on her (up to 45 minutes) without self-seperating. Even after staying at her breast for this time, he would come off and still act hungry, eating up to 50mL of milk that we had previously stored. At this time, my wife could pump about 30-45mL per side so the milk was available.

We are still taking him to the breast 1st, but have been using the feeding tube method and a finger tip to feed him when he shows little to no interest in the breast. He will still latch and appear to suckle but still comes off hungry and eats a decent amount after. When finger feeding he will suck very hard, especially when attempting to remove the finger from hims mouth prematurely. This sounds a lot like what I've read in other posts about nipple confusion but the fact that he will latch but not really feed has us at a loss. Any thoughts/advice on how to get him to suckle like he should.

Re: 9 day old latches, won't suck

Welcome to the forum and congratulations on the new baby! Sorry things have gotten off to such a rough start. The "take 24 hours off" advice is good advice for a lot of moms. I just wish more LCs and IBCLCs would temper it, and tell moms to try to nurse a couple of times per day during that 24 hours, just to help baby stay familiar with the breast.

"Sucking hard" doesn't necessarily translate to "sucking well". When a baby is latched on correctly, it's very possible for a baby's latch and suction to feel quite gentle, yet still be effective. To understand why this works, put your index finger on the back of your tongue, underneath the soft palate, and suck on it. The tip of your finger will feel little or nothing, because the majority of the sucking motion is happening at the front of the tongue. Likewise, a nipple that is correctly positioned and sitting on the back of the tongue may feel little beyond a gentle tugging.

So, those 45 minute feedings? It's possible the baby is getting more milk than either one of you think, based on how mom feels about the baby's sucking (i.e. hard vs. gentle).

The question is, how do you evaluate whether or not the baby is getting enough milk when nursing? You could just take away the supplemental feedings, nurse as much as possible even if that means CONSTANT feeding, and watch diaper output. It can't come out if it didn't go in, right? The other way to evaluate the baby's feeding effectiveness is more technical, and it requires you to either see an IBCLC or rent a professional scale which is good the 1/10th of an oz. Using the scale- and an IBCLC should have one- you can do before-and-after feeding weights. Subtract the before from the after and voila! You have the baby's intake over the course of the feeding, and you know whether a supplement is necessary.

If baby is a very lazy feeder at the breast, sucking gently and erratically, maybe dozing off when he should be more businesslike, here are some things that may help:
- Keep the lights dim. Newborns often close their eyes in response to bright lights.
- Do breast compressions to speed milk to the baby when suckling slows.
- Keep baby a little bit cool and a little bit annoyed during feedings, if he tends to doze off. Dress him lightly, keep a fan blowing in the room where mom is nursing (not directly on the baby), and rub the soles of his feet or against the grain of his hair using a hand or a damp washcloth.
- Experiment with different nursing positions. Reclined positions are especially useful for keeping a newborn on the breast without mom having to work so hard to hold him- and holding a newborn in nursing position can be exhausting!
- If none of the above is helping, you might want to try switch nursing. In switch nursing, mom latches baby on to breast A. When baby slows down, starts to get really lazy and sleepy, mom takes him off breast A, burps him or changes his diaper, and switches him to breast B. She repeats the process as many times as necessary, until baby will no longer wake. Switch nursing is often good for increasing intake, and also teaches baby that he has to be more businesslike at the breast, because falling asleep means than he gets shifted around and annoyed.

Re: 9 day old latches, won't suck

Is the issue that he is getting some milk at the breast, but more from finger feeding?
Because if he is latching well at breast and able to get milk, is swallowing and your wife is doing well- then I'll share my personal experience-
My newborn nursed non stop. NON STOP. He would be at the breast nursing, he would leave the breast, then immediately return to nurse some more. He cried when he was not at the breast. All he ever wanted was to suck, suck, suck- and that's kind of normal. It's a lot of work to get milk in the early days, babies need a lot of practice. It's good for mum to have the baby at the breast as well as it will help build up her supply. So, take him to the breast, and then take him to the breast some more.
Is mum connecting with a breastfeeding support group or still in touch with her lactation consultant? She may need some extra support until she feels more confident.

Re: 9 day old latches, won't suck

Thanks to both of you for your help! Let me clarify a little bit about our concern. The primary frustration is that she'll spend 45 minutes with him at her breast and when he comes off (is removed by her) he still acts fussy/hungry (hands to mouth, lip-smacking, tongue out, crying), and eats a good amount immediately afterward. Overnight, we tried again and after 45 minutes on her he took in another 60mL by finger feeding because he was so fussy after the breast. Usually after these 2nd feedings he will spit-up a couple teaspoons. I'm starting to think that he's sucking more for comfort than food and the food intake is becoming almost incidental to the soothing.

Will discuss some of the suggestions above with wife and see what we can do. We are seeing the consultant this week, the jaundice and a circumcision interfered with our appointment last week. I think a support group might help as well, will suggest it, spirits are trending down so I'm trying to keep things positive.

Re: 9 day old latches, won't suck

I agree with you- he probably is nursing for comfort. And like the PP said, you can check his diaper output if you're worried about him getting enough to eat.

Babies nurse for comfort and they nurse constantly. It is good for baby to be at the breast. The constant nursing will help build up mum's milk supply. And really, nothing calms a fussy baby like being put to the breast! I too, would drop the supplementary feeding and just let that baby nurse.

So let's talk about how to bring up mum's spirits! Reassure her that she's doing a great job, help her monitor output so that you can reassure her that baby is getting enough milk. When my boys were born, my husband made it his job to change the diapers and track the out put, all I had to do was make the milk! It really helped! Plus he became an expert at swaddling infants- better than I ever was!

Get mum comfortable. A good, comfy chair to nurse in. A Boppy pillow or some other pillow on her lap to help support her arms and the weight of the baby. Have Netflix or a DVR? like movies? Now is a great time to catch on a lot of missed viewing. Is she a reader? My Kindle was and is still my best nursing companion. Try different nursing positions. In the early days, side lying was my favorite. I never would have gotten a wink of sleep if we weren't side lying!

Make sure there's plenty of prepared food in the house. It can be hard for a new mum to find time to cook or make sure her own nutritional needs are getting met. Do you cook? Can you order take out? Can you be the one in charge of clean up? Make sure mum is getting plenty of water. Make sure she has a cup next to her full of whatever she likes to drink.

Are nights the worst? Is baby not sleeping? VERY NORMAL! At this point the common saying is just do whatever works! For some, it's co sleeping. Many are concerned about the safety of co sleeping- so I would encourage you to do research on safe sleeping before trying co sleeping. We did a combination of co sleep, letting baby sleep in the swing (it had a cradle bed and the baby loved the motion, really helped us), and of course- not sleeping. Which just happens.

As much as my husband tried, there wasn't much he could do to get our babies to stop crying. They always wanted to nurse. But I really valued how much he supported me. I could not have done so well without him. Flash forward a year, our boys still nurse and it's their favorite way to sooth- they sleep through the night, and they get supper excited when Dad comes home!

So let her know her hard work now will pay off, and this phase is short lived and it will pass. Newborns nurse non stop in the beginning, but as they grow they will nurse less, sleep more and there will be more balance in your life.

Re: 9 day old latches, won't suck

Originally Posted by @llli*9pinehurst

The primary frustration is that she'll spend 45 minutes with him at her breast and when he comes off (is removed by her) he still acts fussy/hungry (hands to mouth, lip-smacking, tongue out, crying), and eats a good amount immediately afterward.

This is true of many babies. Newborns are very driven to suck, but they don't have a lot of experience with their own satiation cues. A lot of babies will have a perfectly adequate feeding at the breast, and yet still act hungry and take another feeding via bottle or syringe or whatever.

Re: 9 day old latches, won't suck

I assume there is no more jaundice concern? Was baby ever actually tested for jaundice levels?

Health issues aside, As long as the breastfeeding baby's output and weight gain are within normal parameters there is no medical reason to supplement. (usually even jaundice does not require supplements either but that is water under the bridge at this point.)

Even when they ARE needed, supplements are tricky and can cause or exacerbate breastfeeding issues. Supplementing when it is not needed is often very problematic.

Newborn babies WILL very often take a supplemental feeding after nursing even if they do not need to. This is because a young baby needs to suckle most of the time! This is a built in biological imperative. This is why a baby will and MUST, biologically, nurse to sleep and nurse IN their sleep. This is why if you put a pacifier or a bottle nipple or a finger in a baby’s mouth, they will almost always suck on it whether they are hungry or not.

This can be very disheartening for mom who naturally assumes that the baby did not get 'enough' from her when the baby is accepting/sucking on the bottle nipple or syringe or a finger feeder or whatever after nursing. Better to not supplement unless they are needed as evidenced by baby's output (poops) and weight gain, not baby’s behavior.

If supplements truly ARE needed, then you can try giving the supplement before nursing so baby “finishes” at the breast. This can be beneficial for many reasons. Using a small, open cup for needed supplements (like the size of a shotglass for example, in fact, you can use a shotglass) might also work better, as, if it is done properly, it is much easier to allow baby more control over the feeding. Let me know if you would like more info on cupfeeding.

Depending on how the ‘finger feeder’ is being used, even it can possibly cause problems. And basically ANY supplementing if it is not medically needed is going to cause unnecessary problems!

You are at a critical point. Many moms stop breastfeeding unnecessarily because their confidence in their bodies has been undermined by either needed and/or unneeded supplementation. Breastfeeding is a normal part of mothering and by far most mothers and babies can breastfeed with NO PROBLEMS or at least, no extreme problems. Even when there are extreme problems those can be worked through with support and helpful assistance. And even in the very rare circumstances when ongoing supplements are needed, breastfeeding can still continue!

So I strongly suggest, Do not put off a consult with an experienced IBCLC -Are you going to the same IBCLC who your wife consulted in the hospital or someone else? Did you like the IBCLC you saw in the hospital? If you did, or rather, if your WIFE likes her, then great, definitely see her again if that is possible. I do have to mention that it seems to me from your initial post that the problems got worse after your wife followed the advice she got in the hospital to temporarily stop nursing. I do not know why that suggestion was given at that point. Maybe your wife was in so much pain and ready to give up due to the pain, that not nursing and pumping instead seemed the best course of action at that point. This IS advice often given when that is the case and it certainly can be helpful in such cases. But generally speaking, it is also true that breastfeeding can very often continue while latch is fixed & nipples heal. Even when nipples are raw, cracked, bleeding, scabbing etc.

Re: 9 day old latches, won't suck

Yes he was tested for jaundice and it was a concern. Had the kid on a biliblanket for 4 days. Levels are fine now and he's got a nice pink color.

We're going back to the same IBCLC that we saw at the hospital, but i think it's unfair to fully blame her for the issues after her initial advice. If we had tried to push the feeding issue with my wife I think she would have shut-down completely; there's been a delicate line between encouraging her enough to keep trying and feeling like I'm just adding pressure to a fragile situation.

Starting today will see we can just let him do his thing at the breast for as long as he likes and monitor output. Hopefully i don't get vetoed...

Re: 9 day old latches, won't suck

Can you encourage your wife to join the forum? Sometimes it's hard to take breastfeeding advice from your male partner, even when the advice is good and the intentions are the best in the world. And being a new mom- it can be very isolating. It might help her to hear "yes, it's normal, you're doing great" from other moms.